MORE THAN 100,000 NOW IN PILOT MEDICARE HEALTH SUPPORT PROGRAMS
PROGRAMS HELP BENEFICIARIES WITH CHRONIC CONDITIONS
More than 100,000 Medicare beneficiaries are now participating in the voluntary Medicare Health Support programs designed to reduce health risks and improve the quality of life for chronically ill patients, the Centers for Medicare & Medicaid Services announced today.
“With more than 100,000 people with Medicare already participating, we expect to learn about how we can support the best possible quality of care for our beneficiaries with chronic conditions,” said CMS Administrator Mark B. McClellan, M.D., Ph.D.
Chronic conditions are a leading cause of illness, disability and death among Medicare beneficiaries and account for a disproportionate share of health care expenditures. For example, about 14 percent of Medicare beneficiaries have congestive heart failure, but they account for 43 percent of Medicare spending. About 18 percent of Medicare beneficiaries have diabetes, yet they account for 32 percent of Medicare spending.
Commonly, beneficiaries who live with multiple chronic conditions have heavy self-care burdens and experience poor health outcomes, increased costs and diminished quality of life, despite the best efforts of their physicians and other health care professionals. There is evidence that self-care support, education and assistance in coordinating care for people with these conditions can be effective in improving clinical outcomes, reducing their healthcare costs and improving participant and provider satisfaction.
Medicare Health Support connects program participants with specially trained health professionals. The eight pilot programs offer guidance and other support to help these chronically ill beneficiaries manage their health, adhere to their physicians’ plans of care and reduce their health risks. The organizations' interventions include personalized care plans, the use of biometric monitoring devices (for weight, blood pressure and pulse), 24 hour telephonic nurse access and group education and support sessions.
Congress created the Medicare Health Support programs as part of the Medicare Prescription Drug Improvement and Modernization Act in December 2003. The pilots were announced in December 2004.
“Medicare Health Support is an innovative approach to care that represents a key priority for the future of Medicare,” said McClellan. “We are committed to improving the quality of care and quality of life for chronically ill beneficiaries, leading to fewer complications and overall health care cost savings.”
Using historical claims data, CMS identified beneficiaries in the pilot regions who are candidates for Medicare Health Support. More than 160,000 beneficiaries have been invited to participate in these programs, which began operations between August 2005 and January 2006. The first programs have been operational less than six months and the positive response from beneficiaries, their caregivers and physicians has been extremely positive. Medicare Health Support programs are operating in the following regions:
- Oklahoma (LifeMasters Supported Selfcare, Inc.) started August 1, 2005
- Washington , DC & Maryland (American Healthways, Inc.) started August 1, 2005
- Western Pennsylvania (Health Dialog Services Corporation) started August 15, 2005
- Mississippi (McKesson Health Solutions, LLC) started August 22, 2005
- Northwest Georgia (CIGNA Healthcare) started September 12, 2005
- Illinois (Aetna Health Management, LLC) started September 1, 2005
- Central Florida (Green Ribbon Healthsm) started November 1, 2005
- Tennessee (XLHealth Corporation, Inc.) started January 16, 2006
More information about the program is available online at http://www.cms.hhs.gov/CCIP/.